The present study includes baseline data from 2867 students (77.8% from Sweden, 22.2% from US) and evaluates the relationships among self-reported disabilities, alcohol use, other substance use, and psychosocial adjustment. There were 114 (4.6%) ‘‘hard-of-hearing’’ (HH) students, 129 (5.2%) reported visual disabilities, 33 (1.3%) reported motor disabilities, 223 (9.0%) reported a reading/writing disability, and 97 (3.6%) reported they had ‘‘other’’ disabilities. Of these, 70 (14.1%) reported more than one disability. Presence of a disability was significantly higher among Sweden students (2 (1)=19.93, p< 0.001), with 19.1% of Sweden students and 11.5% of US students reporting at least one disability. Reporting any type of disability was associated with significantly greater alcohol use frequency, intensity, and related problems (all p < 0.02), significantly more mental health symptoms and conduct problems (p < 0.005), and significantly greater likelihood of illicit and prescription drug use (all p < 0.001). With respect to specific disabilities, individuals with motor disabilities reported the highest levels of alcohol use and mental health symptoms, whereas individuals who reported ‘‘other’’ disabilities had higher rates of illicit drug use and conduct problems. Further, there was a significantly positive correlation between the number of disabilities and intensity of alcohol use, mental health symptoms, conduct problems, illicit and prescription drug use, and alcohol related problems (all p < 0.001). The association between conduct problems and disability (any disability and number of disabilities) was moderated by country of origin, gender, and drinking for coping reasons on the Drinking Motives Questionnaire. Participants in Sweden, males, and those who drank for coping reasons were more likely to report a relationship between disability and conduct problems (p < 0.001). Participants who drank for coping reasons were also more likely to report a relationship between disability and alcohol related problems (p=0.001). These findings indicate students with disabilities are an important risk group for preventive interventions for alcohol, substance, and mental health problems, and may benefit from interventions which target healthy coping skills. This research was supported by NIAAA # 5R01AA018276 awarded to Drs. Larimer & Berglund